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103

Shoulder

Hints in General

• Topogram: AP, 256 mm.

• Patient positioning:

Patient lying in supine position, the uninjured arm
placed above the head, the injured arm placed flat
against his body. If only one side is under investiga-
tion, position this side in the center and support the
other side with a Bocollo pillow (optional).

• If only one side is examined, it is advisable to enter

the side in the comment line on the routine card.

• To further optimize MPR image quality we recommend

that you reduce one or more of the following: colli-
mation, reconstruction increment, pitch factor while
using a wider slice width for image reconstruction.

Body kernels:

• As standard kernels for body tissue studies B30s or

B40s are recommended; softer images are obtained
with B20s or B10s (extremely soft). The kernels B31s
or B41s have about the same visual sharpness as B30s,
respectively, B40s, the image appearance, however,
is more agreeable due to a ”fine-grained” noise struc-
ture; quite often, the low contrast detectability is
improved by using B31s, B41s instead of B30s, B40s.

• The 2 kernels B35s and B46s are especially designed

for cardiac application, in particular, B35s should be
used for Ca-scoring, and B46s for patency of stents.

• For higher sharpness, as is required e.g. in patient

protocols for cervical spine, shoulder, extremities,
thorax, lung, the kernels B50s, B60s, B70s, B80s are
available.

• A special high resolution lung kernel is supplied 

with B90s; by using kernel B90s, practically the same
image impression is obtained as with HCE-filtering of
a B40s image.

Summary of Contents for SOMATOM Emotion 6

Page 1: ...SOMATOM Emotion 6 Application Guide Routine Protocols Software Version A70 ...

Page 2: ... the accuracy of this information Variations may prove necessary for individual patients The treating physician bears the sole responsibility for all of the parameters selected The pertaining oper ating instructions must always be strictly followed when operating the SOMATOM Emotion 6 The statutory sources for the technical data are the corresponding data sheets We express our sincere gratitude to...

Page 3: ...3 3 Overview General 8 Children 24 Head 76 Neck 92 Shoulder 102 Thorax 106 Abdomen 134 Pelvis 164 Spine 172 Extremities 182 ...

Page 4: ... and Slice Width 9 Pitch 11 Recon Job 11 Kernels 12 Image Filter 12 Effective mAs 14 Dose Information 15 CTDIW and CTDIVol 15 CARE Dose 17 How Does it Work 17 Workflow 19 Auto Load in 3D and Postprocessing Presets 19 Contrast Medium IV Injection 20 How to Create your own Scan Protocols 21 ...

Page 5: ...4 Head 36 HeadSeq 37 Sinus 38 InnerEar 40 NeckRoutine 42 CarotidCTA 44 CarotidCTA06s 46 NeonateBody 48 NeonateBody06s 49 ThoraxRoutine 50 ThoraxRoutine06s 52 ThoraxCombi 54 ThoraxCombi06s 56 ThoraxSeqHR 58 AbdPelRoutine 60 AbdPelRoutine06s 62 AbdCTA 64 AbdCTA06s 66 Spine 68 SpineSagittal 70 Extremity 72 ExtrHR 74 ...

Page 6: ... 93 AngioCarotid 94 AngioCarotid06s 96 NeckRoutine 98 NeckThinSlice 100 Shoulder 102 Overview 102 Hints in General 103 Shoulder 104 Thorax 106 Overview 106 Hints in General 108 LungLowDose 110 LungLowDose06s 112 Embolism 114 Embolism06s 116 ThoraxCombi 118 ThoraxCombi06s 120 ThoraxRoutine 122 ThoraxRoutine06s 124 ThoraxFast 126 ThoraxFast06s 128 ThoraxHR 130 ThoraxSeqHR 132 ...

Page 7: ...8 C Spine 180 Extremities 182 Overview 182 Hints in General 183 AngioRunOff 186 AngioRunOff06s 188 ExtrCombi 190 ExtrHR 192 Abdomen 134 Overview 134 Hints in General 136 AbdRoutine 140 AbdRoutine06s 142 AbdomenCombi 144 AbdomenCombi06s 146 AbdMultiPhase 148 AbdMultiPhase06s 150 AbdFast 152 AbdFast06s 154 AngioFast 156 AngioFast06s 158 AngioRoutine 160 AngioRoutine06s 162 ...

Page 8: ...ses Routine uses either 1 0 mm or 2 0 mm slice colli mation depending on the region of interest for routine studies ThinSlice uses 1 0 mm slice collimation for thin slice studies HR uses 0 5 mm optional or 1 0 mm slice colli mation and rotation time of 1 0 s for High resolution studies Combi uses 1 0 mm as slice collimation and by default has 2 reconstruction jobs one thin slice width for HiRes or...

Page 9: ...on and Slice Width Slice collimation is the slice thickness resulting from the effect of the tube side collimator and the adaptive detector array design In Multislice CT the Z coverage per rotation is given by the product of the number of active detector slices and the collimation e g 6 x 1 0 mm Slice width is the true thickness of the reconstructed image With the SOMATOM Emotion 6 you select the ...

Page 10: ...and Slice Width for Spiral Mode 0 5 mm 0 63 0 75 1 1 25 2 2 5 3 4 5 mm optional 1 mm 1 25 2 2 5 3 4 5 6 8 10 mm 2 mm 2 5 3 4 5 6 8 10 mm 3 mm 4 5 6 8 10 mm Cardio Spiral Modes 1 mm 1 25 2 3 mm 2 mm 2 5 3 5 mm Slice Collimation and Slice Width for Sequence Mode 1 0 mm 1 0 2 0 3 0 mm 2 0 mm 2 4 6 12 mm 3 0 mm 3 6 9 18 mm 5 0 mm 5 10 mm Perfusion Multiscan Modes 1 mm 1 2 3 mm 2 mm 2 4 6 12 mm 3 mm 3 ...

Page 11: ... time is defined the software will adapt the table feed per rotation accordingly The Pitch Factor can be freely adapted from 0 5 1 8 Recon Job In the Recon card you can define up to 3 reconstruction jobs with different parameters either before or after you acquire the data When you click on Recon they will all be done automatically In case you want to add another recon job simply click the little ...

Page 12: ...6s B50s B60s B70s B80s B90s 12 head kernels H10s H20s H21s H30s H31s H40s H41s H50s H60s H70s H80s H90s 3 child head kernels C20s C30s C60s 4 special kernels S30s S80s S90s U90s Note Do not use different kernels for other body parts other than what they are designed for For further information regarding the kernels please refer to the Hints in General of the corresponding body region Image Filter ...

Page 13: ... con trast are preserved LCE The Low contrast enhancement LCE filter enhances low contrast detectability It reduces the image noise HCE The High contrast enhancement HCE filter enhances high contrast detectability It increases the image sharpness Reconstruction with PFO filter Reconstruction without PFO filter ...

Page 14: ...ake it easier for the users the concept of the effective mAs was introduced with the SOMATOM Multislice scanners The effective mAs takes into account the influence of pitch on both the image quality and dose Effective mAs mAs Pitch Factor To calculate the dose on the SOMATOM Emotion 6 you simply have to multiply the CTDIW per mAs with the effective mAs of the scan Dspiral DCTDIw x effective mAs Fo...

Page 15: ... scanned volume The CTDIW definition and measurement is based on single axial scan modes For clinical scanning i e scan ning of entire volumes in patients the average dose will also depend on the table feed in between axial scans or the feed per rotation in spiral scanning The dose expressed as the CTDIW must therefore be corrected by the pitch factor of the spiral scan or an axial scan series to ...

Page 16: ...to take into account the scan parameters the system design of individual scanner such as x ray filtration and gantry geometry the scan range the organs involved in the scanned range and the organs affected by scattered radiation For each organ the respective dose delivered during the CT scanning has to be calculated and then multiplied by its radiation risk factor Finally the weighted organ dose n...

Page 17: ...nds the capacity for volume scan ning with thinner slices larger volumes or Multi phase studies It can also improve image quality by increasing mA thus reducing image noise on the lateral views How Does it Work It reduces the mA for low attenuation views up to 90 and keeps the nominal higher mA for high attenuation views e g in the lateral projection Fig 4 This is done on the fly i e the scanner a...

Page 18: ...otocol However the mAs must be adapted manu ally for obese and pediatric patients The mean value of the mAs applied will be lower than what you have selected Although the average mA for the entire scan will be lower than selected we allow the scanner to apply increased mA levels for the high attenuation views This may cause different results of the tube load controller when switching on and off CA...

Page 19: ...ility to create MPR MIPthin Range Parallel and Radial protocols which can be linked to a special series For example if you always do sagittal Multiplanar Reconstructions for a Spine examination you load once a Spine examination into the 3D Card Select the image type MPR MIPthin select the orientation and open the Range Parallel function Adapt the range settings Image thickness Distance between the...

Page 20: ...l no more than 3 ml per kg of body weight for adults and 2 ml per kg of body weight for children should be applied As a rule of thumb the contrast medium injection should be stopped when the scan or acquisition is finished Keep this in mind as you may save contrast medium on your routine studies since the Multislice spiral scan can be up to 10 times faster than a 1 second single slice spiral scan ...

Page 21: ...t the gantry panel or on the topogram routine card Modify the scan protocol change parameters add new ranges etc Do not load the scan protocol Select Edit Save Scan Protocol in the main menu Select the organ region and the scan protocol name in the pop up dialog You can either use the same name to modify the existing scan protocol or enter a new name which will create a new protocol name and will ...

Page 22: ...e list and to distinguish them from the Siemens defaults Do not use special characters like or blank within scan protocol names Do not rename scan protocol files on Windows NT level this will lead to inconsistencies Do not mix head and body scan protocols e g do not save a head mode in the abdomen directory System Run offers the tool Restore Default Scan Protocols which allows you to remove user s...

Page 23: ...23 General ...

Page 24: ...are written in additional lines in the chronicle Whenever possible 80 kV or 110 kV are used instead of 130 kV either to exploit the significantly higher image contrast of iodine contrast media at 80 kV or to reach a lower dose level than possible with 130 kV Head Angio For head CT Angio studies HeadAngio06s For head CT Angio studies using a 0 6 sec rotation time optional Head For routine head spir...

Page 25: ...6 sec rotation time optional ThoraxSeqHR High resolution sequential mode for lung studies AbdPelRoutine For routine abdominal spiral studies AbdPelRoutine06s For routine abdominal spiral studies using a 0 6 sec rotation time optional AbdCTA For abdominal CT Angio studies AbdCTA06s For abdominal CT Angio studies using a 0 6 sec rotation time optional Spine For routine spine spiral studies Spine Sag...

Page 26: ...t the patient is positioned in the center 4 Warm surroundings and dimmed lighting are help ful to make children more cooperative 5 Sedation Although the advent of the Multislice CT scanner has enabled the user to scan through an area of interest much faster than ever sometimes patient motion can still lead to severe motion artifacts seen on the resultant images This becomes a factor especially wit...

Page 27: ...trast agents such as water are becoming more popular for delineation of stomach or bowel wall borders or when 3D recon structions are needed The user needs to be aware of all the contraindications of any of the contrast agents they are using It is recommended to refer to the spe cific vendors recommendations regarding this 7 I V contrast administration In general 1 2 ml per kg of body weight shoul...

Page 28: ...ications when the lowest achievable mAs at 110 kV was still higher than necessary for sufficient noise level for technical reasons generators need to operate at a certain mini mum current for stable operation For applications such as neonate or airway scanning the low tube out put at 80 kV can be used to further reduce the dose to the patient 9 Please observe the recommended mAs settings in the ch...

Page 29: ... are obtained with H30s or H20s H10s sharper images with H50s The kernels H21s H31s H41s yield the same visual sharpness as H20s H30s H40s but a more agreeable image appearance and sometimes even better low contrast detectability the reason is as with B31s and B41s the fine grained noise structure For the standard head protocols we propose H21s H31s H41s High resolution head studies should be perf...

Page 30: ...contrast detectability is improved by using B31s B41s instead of B30s B40s The 2 kernels B35s and B46s are especially designed for cardiac application in particular B35s should be used for Ca scoring and B46s for patency of stents For higher sharpness as is required e g in patient protocols for cervical spine shoulder extremities thorax the kernels B50s B60s B70s B80s are avail able A special high...

Page 31: ...cy and acceptance tests S80s U90s or for specification purposes U90s For special patient protocols S80s and U90s are chosen e g for osteo S80s and for high resolution bone studies U90s We recommend to use the high resolution specifi cation kernel U90s only with small objects like the wrist otherwise artifacts will occur in the images ...

Page 32: ... cm will be covered in 6 9 sec HeadCTA kV 80 Effective mAs Slice collimation 1 0 mm Slice width 1 25 mm Feed Rotation 9 0 mm Rotation time 0 8 sec Kernel C30s Increment 0 8 mm Image order ca cr The mAs should be adjusted to the age of the child Age kV mAs CTDIVol mGy 6 years 80 80 6 5 6 years 12 years 80 120 9 8 Children ...

Page 33: ... of body weight Children MIPthin HeadAngio coronal Image thickness 3 Distance between images 3 Number of images 35 For the 1st reconstruction the Autoload into MIPthin Range on the 3D Card is activated The images will be automatically loaded into 3D MIPthin and a coronal MIPthin Range will pop up Please notice if you are not satisfied with the Range preset adapt the parameters to your needs and li...

Page 34: ...ime A range of 6 cm will be covered in 5 2 sec HeadCTA kV 80 Effective mAs Slice collimation 1 0 mm Slice width 1 25 mm Feed Rotation 9 0 mm Rotation time 0 6 sec Kernel C30s Increment 0 8 mm Image order ca cr The mAs should be adjusted to the age of the child Age kV mAs CTDIVol mGy 6 years 80 80 6 5 6 years 12 years 80 120 9 8 Children ...

Page 35: ...y loaded into 3D MIPthin and a coronal MIPthin Range will pop up Please notice if you are not satisfied with the Range preset adapt the parameters to your needs and link them to the series Tips Children who are more than 12 years old should be scanned with an adult protocol Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size Access site Total amount 1 2 ml ...

Page 36: ...otocol as the skull by this time is fully grown When bone structure is of interest use kernel C60s for image reconstruction Posterior Fossa Optimization Filter PFO To reduce beam hardening artifacts in head images particularly in the base of the skull use the Posterior Fossa Optimization PFO filter Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size Access ...

Page 37: ...this time is fully grown When bone structure is of interest use kernel C60s for image reconstruction Posterior Fossa Optimization Filter PFO To reduce beam hardening artifacts in head images particularly in the base of the skull use the Posterior Fossa Optimization PFO filter Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size Access site Total amount 1 2 m...

Page 38: ...nded e g sinusitis pneu matization polyposis malformations tumors etc A range of 4 cm will be covered in 8 7 sec Sinus 2nd reconstr kV 110 Effective mAs Slice collimation 1 0 mm Slice width 3 0 mm 1 25 mm Feed Rotation 6 0 mm Rotation time 1 0 sec Kernel C30s C60s Increment 3 0 mm 0 8 mm Image order ca cr The mAs should be adjusted to the age of the child ...

Page 39: ...ent Flow rate dependent upon needle size Access site Total amount 1 2 ml per kg of body weight Age kV mAs CTDIVol mGy 3 years 110 35 6 6 3 years 6 years 110 50 9 5 MPRthick Sinus coronal Image thickness 2 Distance between images 2 Number of images 30 For the 2nd reconstruction the Autoload into the MPR Range on the 3D Card is activated The images will be automatically loaded into 3D MPR and a coro...

Page 40: ...ogies of the mastoid process tumor processes of the pyramids posttraumatic changes etc A range of 4 cm will be covered in 15 4 sec InnerEar kV 110 Effective mAs Slice collimation 0 5 mm Slice width 0 63 mm Feed Rotation 3 0 mm Rotation time 1 0 sec Kernel H90s Increment 0 5 mm Image order ca cr The mAs should be adjusted to the age of the child ...

Page 41: ...is time is fully grown When soft tissue is of interest use kernel H30s H31s for image reconstruction Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size Access site Total amount 1 2 ml per kg of body weight Age kV mAs CTDIVole mGy 3 years 110 30 5 9 3 years 6 years 110 50 9 9 ...

Page 42: ...mm Rotation time 0 8 sec Kernel B50s Increment 3 0 mm Image order ca cr Tips Children who are more than 6 years old should be scanned with an adult protocol Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size Access site Total amount 1 2 ml per kg of body weight The mAs should be adjusted to the age of the child Age kV mAs CTDIVol mGy 3 years 110 35 2 7 3 y...

Page 43: ...43 Children ...

Page 44: ... A range of 20 cm will be covered in 19 4 sec CTA 2nd reconstr kV 80 Effective mAs Slice collimation 1 0 mm Slice width 3 0 mm 1 25 mm Feed Rotation 9 0 mm Rotation time 0 8 sec Kernel B41s B31s Increment 3 0 mm 0 8 mm Image order ca cr The mAs should be adjusted to the age of the child Age kV mAs CTDIVol mGy 6 years 80 40 1 4 6 years 12 years 80 60 2 1 Children ...

Page 45: ...site Total amount 1 2 ml per kg of body weight MIPthin CarotidCTA coronal Image thickness 3 Distance between images 3 Number of images 20 For the 2nd reconstruction the Autoload into MIPthin Range on the 3D Card is activated The images will be automatically loaded into 3D MIPthin and a coronal MIPthin Range will pop up Please notice if you are not satisfied with the Range preset adapt the paramete...

Page 46: ...sec rotation time A range of 20 cm will be covered in 14 6 sec CTA 2nd reconstr kV 80 Effective mAs Slice collimation 1 0 mm Slice width 3 0 mm 1 25 mm Feed Rotation 9 0 mm Rotation time 0 6 sec Kernel B41s B31s Increment 3 0 mm 0 8 mm Image order ca cr The mAs should be adjusted to the age of the child Age kV mAs CTDIVol mGy 6 years 80 40 1 4 6 years 12 years 80 60 2 1 Children ...

Page 47: ...site Total amount 1 2 ml per kg of body weight MIPthin CarotidCTA coronal Image thickness 3 Distance between images 3 Number of images 20 For the 2nd reconstruction the Autoload into MIPthin Range on the 3D Card is activated The images will be automatically loaded into 3D MIPthin and a coronal MIPthin Range will pop up Please notice if you are not satisfied with the Range preset adapt the paramete...

Page 48: ...Slice collimation 2 0 mm Slice width 5 0 mm Feed Rotation 18 0 mm Rotation time 0 8 sec Kernel B41s Increment 4 0 mm Image order cr ca CTDIVol 1 1 mGy Tips You can modify the slice width for image reconstruc tion according to the clinical indications Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size Access site Total amount 1 2 ml per kg of body weight Ch...

Page 49: ...ffective mAs 35 Slice collimation 2 0 mm Slice width 5 0 mm Feed Rotation 18 0 mm Rotation time 0 6 sec Kernel B41s Increment 4 0 mm Image order cr ca CTDIVol 1 1 mGy Tips You can modify the slice width for image reconstruc tion according to the clinical indications Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size Access site Total amount 1 2 ml per kg o...

Page 50: ...50 ThoraxRoutine Indications Spiral mode for routine thorax studies e g pneumonia tumors metastases lymphoma vascular abnormalities etc A range of 15 cm will be covered in 8 3 sec Children ...

Page 51: ...ith an adult protocol The first and second recon jobs are defined for visualization of the mediastinum and the lungs respectively Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size Access site Total amount 1 2 ml per kg of body weight The mAs should be adjusted to the body weight of the child Body weight kV mAs CTDIVol mGy 15 kg 110 13 1 0 15 24 kg 110 17 ...

Page 52: ...outine06s Indications Spiral mode for routine thorax studies e g pneumonia tumors metastases lymphoma vascular abnormalities etc using a 0 6 sec rotation time A range of 15 cm will be covered in 6 2 sec Children ...

Page 53: ...ith an adult protocol The first and second recon jobs are defined for visualization of the mediastinum and the lungs respectively Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size Access site Total amount 1 2 ml per kg of body weight The mAs should be adjusted to the body weight of the child Body weight kV mAs CTDIVol mGy 15 kg 110 13 1 0 15 24 kg 110 17 ...

Page 54: ...ral scan E g thorax studies in general and interstitial changes in the lungs There are two recon jobs predefined The first one with 3 mm slice thick ness for the mediastinum the second reconstruction with 1 25 mm slice thickness for the lung A range of 15 cm will be covered in 15 sec Children ...

Page 55: ... examined with an adult protocol Two recon jobs are predefined for image reconstruc tion of routine thorax and thin slice lung Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size Access site Total amount 1 2 ml per kg of body weight The mAs should be adjusted to the body weight of the child Body weight kV mAs CTDIVol mGy 15 kg 110 20 15 24 kg 110 26 2 4 25 ...

Page 56: ...horax studies in general and interstitial changes in the lungs There are two recon jobs predefined The first one with 3 mm slice thickness for the mediastinum the second recon struction with 1 25 mm slice thickness for the lung using a 0 6 sec rotation time A range of 15 cm will be covered in 11 2 sec Children ...

Page 57: ... examined with an adult protocol Two recon jobs are predefined for image reconstruc tion of routine thorax and thin slice lung Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size Access site Total amount 1 2 ml per kg of body weight The mAs should be adjusted to the body weight of the child Body weight kV mAs CTDIVol mGy 15 kg 110 20 15 24 kg 110 26 2 6 25 ...

Page 58: ... order cr ca Tips Children with a body weight of more than 54 kg should be examined with an adult protocol If you want to acquire the patient at full inspiration or full expiration you should practice the breathing with the patient a few times before beginning the scan so that reproducibility may be improved The mAs should be adjusted to the body weight of the child Body weight kV mAs CTDIVol mGy ...

Page 59: ...59 Children ...

Page 60: ...ice width 5 0 mm Feed Rotation 18 0 mm Rotation time 0 8 sec Kernel B41s Increment 5 0 mm Image order cr ca The mAs should be adjusted to the body weight of the child Children Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size Access site Total amount 1 2 ml per kg of body weight Body weight kV mAs CTDIVol mGy 15 kg 110 15 1 2 15 24 kg 110 30 2 4 25 34 kg ...

Page 61: ...61 Children Tips Children with a body weight of more than 55 kg should be examined with an adult protocol ...

Page 62: ...imation 2 0 mm Slice width 5 0 mm Feed Rotation 18 0 mm Rotation time 0 6 sec Kernel B41s Increment 5 0 mm Image order cr ca The mAs should be adjusted to the body weight of the child Children Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size Access site Total amount 1 2 ml per kg of body weight Body weight kV mAs CTDIVol mGy 15 kg 110 15 1 2 15 24 kg 110...

Page 63: ...63 Children Tips Children with a body weight of more than 55 kg should be examined with an adult protocol ...

Page 64: ...age order cr ca The mAs should be adjusted to the body weight of the child Children Body weight kV mAs CTDIVol mGy 15 kg 80 40 1 4 15 24 kg 80 60 2 1 25 34 kg 80 80 2 8 35 44 kg 80 100 3 5 45 54 kg 80 130 4 6 For the 2nd reconstruction the Autoload into MIPthin Range on the 3D Card is activated The images will be automatically loaded into 3D MIPthin and a sagittal MIPthin Range will pop up Please ...

Page 65: ...size Access site Total amount 1 2 ml per kg of body weight Tips Children with a body weight of more than 54 kg should be examined with an adult protocol The first recon job is defined for image viewing and filming MIPthin AbdCTA sagittal Image thickness 3 Distance between images 3 Number of images 60 ...

Page 66: ...t 3 0 mm 0 8 mm Image order cr ca The mAs should be adjusted to the body weight of the child Children Body weight kV mAs CTDIVol mGy 15 kg 80 40 1 4 15 24 kg 80 60 2 1 25 34 kg 80 80 2 8 35 44 kg 80 100 3 5 45 54 kg 80 130 4 6 For the 2nd reconstruction the Autoload into MIPthin Range on the 3D Card is activated The images will be automatically loaded into 3D MIPthin and a sagittal MIPthin Range w...

Page 67: ...size Access site Total amount 1 2 ml per kg of body weight Tips Children with a body weight of more than 54 kg should be examined with an adult protocol The first recon job is defined for image viewing and filming MIPthin AbdCTA sagittal Image thickness 3 Distance between images 3 Number of images 60 ...

Page 68: ... reconstr kV 110 Effective mAs Slice collimation 2 0 mm Slice width 3 0 mm 3 0 mm Feed Rotation 12 0 mm Rotation time 1 0 sec Kernel B41s B60s Increment 1 5 mm 1 5 mm Image order cr ca The mAs should be adjusted to the body weight of the child Children Body weight kV mAs CTDIVol mGy 15 kg 110 22 1 7 15 24 kg 110 47 3 7 25 34 kg 110 78 6 0 35 44 kg 110 110 8 6 45 55 kg 110 173 13 5 ...

Page 69: ...n needle size Access site Total amount 1 2 ml per kg of body weight Tips Children with a body weight of more than 55 kg should be examined with an adult protocol If the study is focused on bone structures only the mAs can be reduced up to 30 for children with a body weight of more than 25 kg ...

Page 70: ...nel B41s B60s Increment 0 8 mm 0 8 mm Image order cr ca The mAs should be adjusted to the body weight of the child Children Body weight kV mAs CTDIVol mGy 15 kg 110 40 3 5 15 24 kg 110 50 4 4 25 34 kg 110 60 5 2 35 44 kg 110 70 6 1 45 55 kg 110 80 7 0 For the 2nd reconstruction the Autoload into the MPR Range on the 3D Card is activated The images will be automatically loaded into 3D MPR and a sag...

Page 71: ...l per kg of body weight Tips Children with a body weight of more than 55 kg should be examined with an adult protocol If the study is focused on bone structures only the mAs can be reduced up to 30 for children with a body weight of more than 25 kg MPRthick Spine sagittal Image thickness 3 Distance between images 3 Number of images 20 ...

Page 72: ...70s Increment 3 0 mm 0 8 mm Image order cr ca The mAs should be adjusted to the body weight of the child Children Body weight kV mAs CTDIVol mGy 15 kg 110 15 1 4 15 34 kg 110 25 2 3 35 54 kg 110 50 4 5 For the 2nd reconstruction the Autoload into the MPR Range on the 3D Card is activated The images will be automatically loaded into 3D MPR and a coronal MPRthick Range will pop up Please notice if y...

Page 73: ... per kg of body weight Tips Children with a body weight of more than 54 kg should be examined with an adult protocol If the study is focused on bone structures only the mAs can be reduced up to 30 for children with a body weight of more than 25 kg MPRthick Extremity coronal Image thickness 3 Distance between images 3 Number of images 20 ...

Page 74: ...Feed Rotation 3 0 mm Rotation time 0 8 sec Kernel B41s U90s Increment 3 0 mm 0 3 mm Image order cr ca The mAs should be adjusted to the body weight of the child Body weight kV mAs CTDIVol mGy 15 kg 110 35 3 3 15 34 kg 110 50 4 7 35 54 kg 110 80 7 5 Children For the 2nd reconstruction the Autoload into the MPR Range on the 3D Card is activated The images will be automatically loaded into 3D MPR and...

Page 75: ...75 Tips Children with a body weight of more than 54 kg should be examined with an adult protocol Children MPRthick Extremity coronal Image thickness 3 Distance between images 3 Number of images 20 ...

Page 76: ... of the skull and cerebrum routine studies Head Spiral mode for base of skull and cerebrum routine studies InnerEarSeq Sequence mode for inner ear High Resolution studies using 1 0 mm slice collimation and a 1 0 mm slice thickness InnerEar Spiral mode for inner ear High Resolution studies using 0 5 mm slice collimation optional and a 0 63 mm slice thickness OrbiSinus Spiral mode for orbital and si...

Page 77: ...d by hand injection Start the scan after the injection is completed To further optimize MPR image quality we recommend that you reduce one or more of the following colli mation reconstruction increment pitch factor while using a wider slice width for image reconstruction Head kernels For soft tissue head studies the standard kernel is H40s softer images are obtained with H30s or H20s H10s sharper ...

Page 78: ...Indications Spiral mode for cerebral CT Angios e g cerebral vascular abnormalities tumors and follow up studies etc Two recon jobs are predefined for postprocessing A range of 80 mm will be covered in 12 3 sec Head ...

Page 79: ... trigger threshold at 120 HU or use manual triggering MIPthin AngioHead coronal Image thickness 3 Distance between images 3 Number of images 35 For the 2nd reconstruction the Autoload into MIPthin Range on the 3D Card is activated The images will be automatically loaded into 3D MIPthin and a coronal MIPthin Range will pop up Please notice if you are not satisfied with the Range preset adapt the pa...

Page 80: ...ons Spiral mode for cerebral CT Angios e g cerebral vascular abnormalities tumors and follow up studies etc using a 0 6 sec rotation time Two recon jobs are predefined for postprocessing A range of 80 mm will be covered in 9 2 sec ...

Page 81: ... trigger threshold at 120 HU or use manual triggering MIPthin AngioHead coronal Image thickness 3 Distance between images 3 Number of images 35 For the 2nd reconstruction the Autoload into MIPthin Range on the 3D Card is activated The images will be automatically loaded into 3D MIPthin and a coronal MIPthin Range will pop up Please notice if you are not satisfied with the Range preset adapt the pa...

Page 82: ...brain tumors cranial trauma cerebral atrophy hydrocephalus and inflammation etc Two ranges are predefined One for the base of the skull and one for the cerebrum the scan length for the entire head is 125 mm For both ranges a typical gantry tilt of 20 is predefined Head 82 ...

Page 83: ...ation time 1 5 sec 1 5 sec Kernel H31s H31s Image order ca cr ca cr CTDIVol 58 8 mGy 63 2 mGy PosteriorFossaOptimization Filter PFO To reduce beam hardening artifacts in head images use for both ranges the Posterior Fossa Optimization PFO filter Contrast medium IV injection Start delay 60 sec Flow rate 2 ml sec Total amount 50 60 ml 83 ...

Page 84: ...in tumors cranial trauma cerebral atrophy hydro cephalus and inflammation etc Two ranges are predefined for the base of the skull and cerebrum A range for the base of 40 mm will be covered in 12 0 sec a range for the cerebrum of 80 mm will be covered in 12 0 sec Head 84 ...

Page 85: ...e 1 0 sec 1 0 sec Kernel H31s H31s Increment 4 0 mm 6 0 mm Image order ca cr ca cr CTDIVol 65 9 mGy 70 7 mGy PosteriorFossaOptimization Filter PFO To reduce beam hardening artifacts in head images use for both ranges the Posterior Fossa Optimization PFO filter Contrast medium IV injection Start delay 60 sec Flow rate 2 ml sec Total amount 50 60 ml 85 ...

Page 86: ...mode for inner ear High Resolution studies e g inflammatory changes tumorous processes of pyramids cerebellopontine angle tumors post traumatic changes etc The scan length is 47 mm and a typical gantry tilt of 20 is predefined Head 86 ...

Page 87: ...m Slice width 1 0 mm Feed Scan 6 0 mm Rotation time 1 0 sec Kernel H90s Image order ca cr CTDIVol 49 4 mGy For image reconstruction of soft tissue use kernel H30s H31s Contrast medium IV injection Start delay 60 sec Flow rate 2 ml sec Total amount 60 ml 87 ...

Page 88: ...A range of 40 cm will be covered in 15 3 sec Head InnerEar kV 130 Effective mAs 150 Slice collimation 0 5 mm Slice width 0 63 mm Feed Rotation 3 0 mm Rotation time 1 0 sec Kernel H90s Increment 0 5 mm Image order ca cr CTDIVol 42 7 mGy For image reconstruction of soft tissue use kernel H30s H31s Contrast medium IV injection Start delay 60 sec Flow rate 2 ml sec Total amount 50 ml 88 ...

Page 89: ...Head 89 ...

Page 90: ...on jobs are predefined for image reconstruction of the soft tissue and bone structure A range of 40 cm will be covered in 8 7 sec Head OrbiSinus 2nd reconstr kV 130 Effective mAs 60 Slice collimation 1 0 mm Slice width 3 0 mm 1 25 mm Feed Rotation 6 0 mm Rotation time 1 0 sec Kernel H31s H70s Increment 3 0 mm 0 8 mm Image order ca cr CTDIVol 16 5 mGy 90 ...

Page 91: ...ill reduce the possibility of small streak artifacts from eye movement If the study is focused on bone structure only you can reduce the mAs to 20 Contrast medium IV injection Start delay 45 sec Flow rate 2 0 ml sec Total amount 75 ml 91 MPRthick Sinus coronal Image thickness 2 Distance between images 2 Number of images 30 For the 2nd reconstruction the Autoload into the MPR Range on the 3D Card i...

Page 92: ...view AngioCarotid For CTA studies AngioCarotid06s For CTA studies using a rotation time of 0 6 sec optional NeckRoutine For routine soft tissue spiral studies NeckThinSlice For soft tissue thin slice spiral studies ...

Page 93: ...ne grained noise struc ture quite often the low contrast detectability is improved by using B31s B41s instead of B30s B40s The 2 kernels B35s and B46s are especially designed for cardiac application in particular B35s should be used for Ca scoring and B46s for patency of stents For higher sharpness as is required e g in patient protocols for cervical spine shoulder extremities thorax lung the kern...

Page 94: ...ons Noninvasive CT angiography of carotid stenosis or occlusions plaques course abnormalities of the carotids and vertebral arteries etc A range of 12 cm will be covered in 12 3 sec Two recon jobs are predefined for postprocessing ...

Page 95: ...iggering threshold of 120 HU or use manual triggering MIPthin AngioCarotid coronal Image thickness 3 Distance between images 3 Number of images 20 For the 2nd reconstruction the Autoload into MIPthin Range on the 3D Card is activated The images will be automatically loaded into 3D MIPthin and a coronal MIPthin Range will pop up Please notice if you are not satisfied with the Range preset adapt the...

Page 96: ...ck AngioCarotid06s Indications Noninvasive CT angiography of carotid stenosis or occlusions plaques course abnormalities of the carotids and vertebral arteries etc A range of 12 cm will be covered in 9 2 sec ...

Page 97: ...iggering threshold of 120 HU or use manual triggering MIPthin AngioCarotid coronal Image thickness 3 Distance between images 3 Number of images 20 For the 2nd reconstruction the Autoload into MIPthin Range on the 3D Card is activated The images will be automatically loaded into 3D MIPthin and a coronal MIPthin Range will pop up Please notice if you are not satisfied with the Range preset adapt the...

Page 98: ...Neck NeckRoutine Indications For soft tissue spiral studies in the cervical region E g tumors lymphoma abscesses etc A typical range of 20 cm will be covered in 10 5 sec 98 ...

Page 99: ...le should be positioned as far as possible in the caudal direction This can be done using a strap with a permanent loop or Velcro fastener at its end The ends of the strap must be attached to the patients wrists Then the strap must be wrapped around the patients feet with his legs extended and under tension The entire thoracic girdle is thus pulled toward the patients feet Contrast medium IV injec...

Page 100: ...ices for soft tissue studies E g the functional study of the throat Two recon jobs are predefined thinner slice recon struction used for post processing and thicker slice reconstruction for soft tissue A typical range of 20 cm will be covered in 28 3 sec 100 ...

Page 101: ...lice width and increment of 0 7 mm for performing MPRs This would help differentiate tumor lesions from normal pharyngeal mucosa Contrast medium IV injection Start delay 45 sec Flow rate 3 ml sec Total amount 100 ml MPRthick NeckThinSlice sagittal Image thickness 3 Distance between images 3 Number of images 20 For the 2nd reconstruction the Autoload into the MPR Range on the 3D Card is activated T...

Page 102: ...102 Shoulder Overview Shoulder Spiral mode for HiRes bone studies and soft tissues ...

Page 103: ...r body tissue studies B30s or B40s are recommended softer images are obtained with B20s or B10s extremely soft The kernels B31s or B41s have about the same visual sharpness as B30s respectively B40s the image appearance however is more agreeable due to a fine grained noise struc ture quite often the low contrast detectability is improved by using B31s B41s instead of B30s B40s The 2 kernels B35s a...

Page 104: ...er Shoulder Indications Spiral mode for HiRes bone studies and soft tissues E g evaluation of joint cavities masses trauma dislocations orthopedic indications etc A scan range of 15 cm will be covered in 21 8 sec ...

Page 105: ...eed Rotation 12 0 mm Rotation time 1 5 sec Kernel B60s Increment 2 0 mm Image order cr ca CTDIVol 9 7 mGy In case of 3D study mAs value can be reduced by 50 Use raw data to review a target region if necessary For image reconstruction of soft tissue use kernel B31s and a slice width of 5 0 mm ...

Page 106: ...ulmonary nodules LungLowDose06s Spiral mode with very low dose and a rotation time of 0 6 sec for special lung studies E g early visuali zation of pulmonary nodules optional Embolism Spiral mode for Pulmonary Emboli studies Embolism06s Spiral mode for Pulmonary Emboli studies using a rotation time of 0 6 sec optional ...

Page 107: ... 6 sec optional ThoraxRoutine For routine thorax spiral studies ThoraxRoutine06s For routine thorax spiral studies using a rotation time of 0 6 sec optional ThoraxFast Fast spiral mode for long range studies ThoraxFast06s Fast spiral mode for long range studies using a rotation time of 0 6 sec optional ThoraxHR Spiral mode for HiRes lung studies ThoraxSeqHR Sequential mode for HiRes lung studies ...

Page 108: ... for monitoring scan in the aorta at the level of the diaphragm with triggering threshold of 120 HU or use manual triggering If the voltage is lowered from 130 kV to 110 kV substantially higher mAs values have to be used at least by a factor of 2 To further optimize MPR image quality we recommend that you reduce one or more of the following colli mation reconstruction increment pitch factor while ...

Page 109: ...trast detectability is improved by using B31s B41s instead of B30s B40s The 2 kernels B35s and B46s are especially designed for cardiac application in particular B35s should be used for Ca scoring and B46s for patency of stents For higher sharpness as is required e g in patient protocols for cervical spine shoulder extremities thorax lung the kernels B50s B60s B70s B80s are available A special hig...

Page 110: ...LungLowDose Indications Lung studies with low dose setting e g early visuali zation of pulmonary nodules A typical thorax study in a range of 30 cm will be covered in 21 6 sec 110 Thorax ...

Page 111: ...ca CTDIVol 1 3 mGy 111 You could repeat the same protocol simply by clicking the chronicle with the right mouse button for repeat E g when both non contrast and contrast studies are required For lung cancer staging this protocol can be combined with protocol Neck Routine Contrast medium IV injection Start delay 30 sec Flow rate 2 5 ml sec Total amount 50 70 ml Thorax ...

Page 112: ...owDose06s Indications Lung studies with low dose setting e g early visuali zation of pulmonary nodules using a 0 6 sec rotation time A typical thorax study in a range of 30 cm will be covered in 16 2 sec Thorax ...

Page 113: ... cr ca CTDIVol 1 3 mGy You could repeat the same protocol simply by clicking the chronicle with the right mouse button for repeat E g when both non contrast and contrast studies are required For lung cancer staging this protocol can be combined with protocol Neck Routine Contrast medium IV injection Start delay 30 sec Flow rate 2 5 ml sec Total amount 50 70 ml Thorax ...

Page 114: ... Emboli studies There are two recon jobs predefined The first one with 3 mm slice thickness for the mediastinum The second reconstruction with 1 25 mm slice thick ness used for postprocessing A range of 28 cm will be covered in 22 4 sec 114 Thorax ...

Page 115: ...ng threshold of 120 HU or use manual triggering Contrast medium IV injection Start delay 12 15 sec Flow rate 4 ml sec Total amount 80 100 ml Thorax MIPthin Embolism coronal Image thickness 3 Distance between images 3 Number of images 35 For the 2nd reconstruction the Autoload into MIPthin Range on the 3D Card is activated The images will be automatically loaded into 3D MIPthin and a coronal MIPthi...

Page 116: ...Emboli studies using a rotation time of 0 6 s There are two recon jobs predefined The first one with 3 mm slice thickness for the mediastinum the second reconstruction with 1 25 mm slice thickness used for postprocessing A range of 28 cm will be covered in 20 sec ...

Page 117: ...triggering threshold of 120 HU or use manual triggering Contrast medium IV injection Start delay 12 15 sec Flow rate 4 ml sec Total amount 80 100 ml MIPthin Embolism coronal Image thickness 3 Distance between images 3 Number of images 35 For the 2nd reconstruction the Autoload into MIPthin Range on the 3D Card is activated The images will be automatically loaded into 3D MIPthin and a coronal MIPth...

Page 118: ... one spiral scan E g thorax studies in general and interstitial changes in the lungs There are two recon jobs predefined The first one with 5 mm slice thickness for the mediastinum the second reconstruction with 1 25 mm slice thick ness for the lung A range of 30 cm will be covered in 23 8 sec ...

Page 119: ...hange the increment before image reconstruction Contrast medium IV injection Start delay 25 sec Flow rate 2 5 ml sec Total amount 80 ml MIPthin ThoraxCombi coronal Image thickness 3 Distance between images 3 Number of images 60 For the 2nd reconstruction the Autoload into MIPthin Range on the 3D Card is activated The images will be automatically loaded into 3D MIPthin and a coronal MIPthin Range w...

Page 120: ...scan E g thorax studies in general and interstitial changes in the lungs using a 0 6 sec rotation time There are two recon jobs predefined The first one with 5 mm slice thickness for the mediastinum the second reconstruction with 1 mm slice thickness for the lung A range of 30 cm will be covered in 21 2 sec ...

Page 121: ...hange the increment before image reconstruction Contrast medium IV injection Start delay 25 sec Flow rate 2 5 ml sec Total amount 80 ml MPRthin ThoraxCombi coronal Image thickness 3 Distance between images 3 Number of images 60 For the 2nd reconstruction the Autoload into MPRthin Range on the 3D Card is activated The images will be automatically loaded into 3D MPRthin and a coronal MPRthin Range w...

Page 122: ...rax ThoraxRoutine Indications Routine spiral studies for the region of thorax e g screening of tumors metastases lymphoma lymph nodes vascular anomalies etc A range of 30 cm will be covered in 16 6 sec 122 ...

Page 123: ...der cr ca CTDIVol 8 0 mGy You could repeat the same protocol simply by clicking the chronicle with the right mouse button for repeat E g when both non contrast and contrast studies are required For lung cancer staging this protocol can be combined with protocol Neck Routine Contrast medium IV injection Start delay 25 30 sec Flow rate 2 5 ml sec Total amount 80 ml 123 ...

Page 124: ...tine06s Indications Routine spiral studies for the region of thorax e g screening of tumors metastases lymphoma lymph nodes vascular anomalies etc using a 0 6 sec rotation time A range of 30 cm will be covered in 12 5 sec ...

Page 125: ...ge order cr ca CTDIVol 8 0 mGy You could repeat the same protocol simply by clicking the chronicle with the right mouse button for repeat E g when both non contrast and contrast studies are required For lung cancer staging this protocol can be combined with protocol Neck Routine Contrast medium IV injection Start delay 25 30 sec Flow rate 2 5 ml sec Total amount 80 ml ...

Page 126: ...126 Thorax ThoraxFast Indications Fast spiral mode for lung studies e g when a patient has difficulty with breathhold A complete thorax scan in a range of 30 cm will be covered in 10 5 sec ...

Page 127: ...e order cr ca CTDIVol 7 5 mGy You could repeat the same protocol simply by clicking the chronicle with the right mouse button for repeat E g when both non contrast and contrast studies are required For lung cancer staging this protocol can be combined with protocol Neck Routine Contrast medium IV injection Start delay 25 30 sec Flow rate 2 5 ml sec Total amount 80 ml ...

Page 128: ...x ThoraxFast06s Indications Fast spiral mode for lung studies e g when a patient has difficulty with breathhold using a 0 6 sec rotation time A complete thorax scan in a range of 30 cm will be covered in 7 9 sec ...

Page 129: ...e order cr ca CTDIVol 7 5 mGy You could repeat the same protocol simply by clicking the chronicle with the right mouse button for repeat E g when both non contrast and contrast studies are required For lung cancer staging this protocol can be combined with protocol Neck Routine Contrast medium IV injection Start delay 25 30 sec Flow rate 2 5 ml sec Total amount 80 ml ...

Page 130: ...iRes studies e g interstitial changes in the lungs Two recon jobs are predefined thinner slice reconstruction used for postprocessing and thicker slice reconstruction for soft tissue A range of 28 cm for the complete thorax will be covered in 26 5 sec ...

Page 131: ...itial changes in the lungs contrast medium is not necessary MPRthick ThoraxHR coronal Image thickness 2 Distance between images 2 Number of images 70 For the 2nd reconstruction the Autoload into the MPR Range on the 3D Card is activated The images will be automatically loaded into 3D MPR and a coronal MPRthick Range will pop up Please notice if you are not satisfied with the Range preset adapt the...

Page 132: ...132 Thorax ThoraxSeqHR Indications Sequence mode for HiRes lung studies E g interstitial changes in the lungs Images are acquired in 10 mm intervals ...

Page 133: ...on 1 0 mm Slice width 1 0 mm Feed Scan 10 0 mm Rotation time 1 0 sec Kernel B90s Image order cr ca CTDIVol 1 0 mGy If you want to reconstruct thin slices every 10 or 20 mm instead of 10 mm as predefined simply change the Feed Scan before loading the mode ...

Page 134: ...a rotation time of 0 6 sec optional AbdCombi Spiral mode for the combination of thin slice and routine abdominal studies AbdCombi06s Spiral mode for the combination of thin slice and routine abdominal studies using a rotation time of 0 6 sec optional AbdMultiPhase Spiral mode for the combination of CTA and two phases soft tissue studies ...

Page 135: ...t mode for abdomen studies AbdFast06s Fast mode for abdomen studies using a rotation time of 0 6 sec optional AngioFast For long range CTA studies AngioFast06s For long CTA studies using a rotation time of 0 6 sec optional AngioRoutine For CTA routine studies AngioRoutine06s For CTA routine studies using a rotation time of 0 6 sec optional ...

Page 136: ... agents can be used Diluted barium suspension 1 2 e g EZCAT Water soluble agent 2 4 e g Gastrografin Water alone as a negative contrast agent Timing of the oral contrast administration is important to ensure its even distribution in the bowel Upper abdomen Minimum 600 ml of contrast divided into 3 cups approximately 200 250 ml 1st cup to drink 30 minutes before exam 2nd cup to drink 15 minutes bef...

Page 137: ...easily afterwards For patients with bowel obstruction only water or water soluble contrast can be used Barium suspension is a contraindication Be careful when examining pheochromocytoma patients Administration of an IV CM injection in such cases may trigger a hypertensive crisis For more information regarding the general use of drugs and doses including specific indications and contraindications m...

Page 138: ...ntrast detectability is improved by using B31s B41s instead of B30s B40s The 2 kernels B35s and B46s are especially designed for cardiac application in particular B35s should be used for Ca scoring and B46s for patency of stents For higher sharpness as is required e g in patient protocols for cervical spine shoulder extremities thorax lung the kernels B50s B60s B70s B80s are available A special hi...

Page 139: ...139 Abdomen ...

Page 140: ... Abdomen AbdRoutine Indications Spiral mode for all routine studies in the region of abdomen e g screening follow up examinations etc A complete abdomen scan in a range of 20 cm will be covered in 12 3 sec ...

Page 141: ...8 sec Kernel B41s Increment 5 0 mm Image order cr ca CTDIVol 10 8 mGy You could repeat the same protocol simply by clicking the chronicle with the right mouse button for repeat E g when both non contrast and contrast studies are required Contrast medium IV injection Start delay 50 60 sec Flow rate 4 0 ml sec Total amount 100 ml ...

Page 142: ...ine06s Indications Spiral mode for all routine studies in the region of abdomen e g screening follow up examinations etc using a 0 6 sec rotation time A complete abdomen scan in a range of 20 cm will be covered in 9 2 sec ...

Page 143: ... 6 sec Kernel B41s Increment 5 0 mm Image order cr ca CTDIVol 10 8 mGy You could repeat the same protocol simply by clicking the chronicle with the right mouse button for repeat E g when both non contrast and contrast studies are required Contrast medium IV injection Start delay 50 60 sec Flow rate 4 0 ml sec Total amount 100 ml ...

Page 144: ... abdominal studies with one spiral scan e g a range of 20 cm for liver pancreas or kidneys will be covered in 19 4 sec Two recon jobs are predefined thinner slice recon struction used for postprocessing and thicker slice reconstruction for soft tissue 144 Abdomen ...

Page 145: ...of MIP SSD VRT images Water could be used instead if necessary You can repeat the same protocol simply by clicking the chronicle with the right mouse button for repeat E g when both non contrast and contrast studies are required Contrast medium IV injection Start delay 50 65 sec Flow rate 4 ml sec Total amount 100 ml 145 Abdomen MIPthin AbdCombi coronal Image thickness 3 Distance between images 3 ...

Page 146: ...nal studies with one spiral scan using a 0 6 sec rotation time A range of 20 cm for liver pancreas or kidneys will be covered in 14 6 sec Two recon jobs are predefined thinner slice recon struction used for postprocessing and thicker slice reconstruction for soft tissue Abdomen ...

Page 147: ...ng of MIP SSD VRT images Water could be used instead if necessary You can repeat the same protocol simply by clicking the chronicle with the right mouse button for repeat E g when both non contrast and contrast studies are required Contrast medium IV injection Start delay 50 65 sec Flow rate 4 ml sec Total amount 100 ml Abdomen MIPthin AbdCombi coronal Image thickness 3 Distance between images 3 N...

Page 148: ...ey arterial phase acquired with 2 0 mm slice collimation in 15 s image reconstructed in 2 5 mm for post processing and 5 mm for soft tissue enhancement Same range followed with a scan range of 35 cm by 2 0 mm slice collimation acquisition in 25 s for venous phase image reconstructed in 5 mm for soft tissue only 148 Abdomen ...

Page 149: ...ted The images will be automatically loaded into 3D MIPthin and coronal MIPthin Range will pop up Please notice if you are not satisfied with the Range preset adapt the parameters to your needs and link them to the series Contrast medium IV injection Start delay 20 25 sec arterial phase 50 75 sec venous phase Flow rate 4 5 ml sec Total amount 100 120 ml 149 Abdomen Non Arterial Venous Contrast pha...

Page 150: ...h a scan range of 35 cm by 2 0 mm slice collimation acquisition in 18 7 s for venous phase image reconstructed in 5 mm for soft tissue only Abdomen Non Arterial Venous Contrast phase phase kV 110 110 130 Effective mAs 60 90 95 Slice collimation 2 0 mm 2 0 mm 2 0 mm Slice width 5 0 mm 5 0 mm 5 0 mm 2 5 mm Feed Rotation 18 0 mm 12 0 mm 12 0 mm Rotation time 0 6 sec 0 6 sec 0 6 sec Kernel B41s B41s B...

Page 151: ...se coronal Image thickness 3 Distance between images 3 Number of images 50 For the 2nd reconstruction of the Arterial Phase the Autoload into the MIPthin Range on the 3D Card is acti vated The images will be automatically loaded into 3D MIPthin and coronal MIPthin Range will pop up Please notice if you are not satisfied with the Range preset adapt the parameters to your needs and link them to the ...

Page 152: ...152 AbdFast Indications Fast spiral mode for abdominal studies e g when a patient has difficulty with breathhold A range of 20 cm will be covered in 7 5 sec Abdomen ...

Page 153: ...ired For lung cancer staging this protocol can be com bined with protocol Neck Routine Contrast medium IV injection Start delay 25 30 sec Flow rate 2 5 ml sec Total amount 80 ml Abdomen AbdFast kV 130 Effective mAs 95 Slice collimation 3 0 mm Slice width 6 0 mm Feed Rotation 27 0 mm Rotation time 0 8 sec Kernel B41s Increment 6 0 mm Image order cr ca CTDIVol 10 1 mGy ...

Page 154: ...154 AbdFast06s Indications Fast spiral mode for abdomen studies using a rotation time of 0 6 sec e g when a patient has difficulty with breathhold A range of 20 cm will be covered in 5 6 sec Abdomen ...

Page 155: ...ired For lung cancer staging this protocol can be com bined with protocol Neck Routine Contrast medium IV injection Start delay 25 30 sec Flow rate 2 5 ml sec Total amount 80 ml Abdomen AbdFast kV 130 Effective mAs 95 Slice collimation 3 0 mm Slice width 6 0 mm Feed Rotation 27 0 mm Rotation time 0 6 sec Kernel B41s Increment 6 0 mm Image order cr ca CTDIVol 10 1 mGy ...

Page 156: ...AngioFast Indications Long range CTA studies E g a typical study of the whole aorta including its branchiocephalic trunk and iliac arteries in a range of 30 cm will be covered in 13 1 sec 156 Abdomen ...

Page 157: ... beginning of the scan range with trigger ing threshold of 120 HU or use manual triggering Contrast medium IV injection Start delay 20 sec Flow rate 3 5 ml sec Total amount 120 ml 157 Abdomen MIPthin AngioFast coronal Image thickness 3 Distance between images 3 Number of images 35 For the 1st reconstruction the Autoload into MIPthin Range on the 3D Card is activated The images will be automaticall...

Page 158: ...s Indications Long range CTA studies using a rotation time 0 6 sec E g a typical study of the whole aorta including its branchiocephalic trunk and iliac arteries in a range of 30 cm will be covered in 9 8 sec Abdomen ...

Page 159: ... the beginning of the scan range with trigger ing threshold of 120 HU or use manual triggering Contrast medium IV injection Start delay 20 sec Flow rate 3 5 ml sec Total amount 120 ml Abdomen MIPthin AngioFast coronal Image thickness 3 Distance between images 3 Number of images 35 For the 1st reconstruction the Autoload into MIPthin Range on the 3D Card is activated The images will be automaticall...

Page 160: ...AngioRoutine Indications For abdominal CTA studies A typical study in a range of 20 cm will be covered in 19 4 sec 160 Abdomen ...

Page 161: ...e abdominal aorta at the beginning of the scan range with trigger ing threshold of 120 HU or use manual triggering MIPthin AngioRoutine sagittal Image thickness 3 Distance between images 3 Number of images 60 For the 2nd reconstruction the Autoload into the MIPthin Range on the 3D Card is activated The images will be automatically loaded into 3D MIPthin and sagittal MIPthin Range will pop up Pleas...

Page 162: ...162 AngioRoutine06s Indications For abdominal CTA studies using a rotation time 0 6 sec E g a typical study in a range of 20 cm will be covered in 14 5 sec Abdomen ...

Page 163: ...n the abdominal aorta at the beginning of the scan range with trigger ing threshold of 120 HU or use manual triggering MIPthin AngioRoutine sagittal Image thickness 3 Distance between images 3 Number of images 60 For the 2nd reconstruction the Autoload into the MIPthin Range on the 3D Card is activated The images will be automatically loaded into 3D MIPthin and sagittal MIPthin Range will pop up P...

Page 164: ...164 Pelvis Overview Hip Spiral mode for HiRes bone and soft tissue studies of the hip PelvisRoutine Spiral mode for routine pelvis studies ...

Page 165: ...luence this region Rectal contrast medium administration Rectal contrast media is usually required to delineate the rectum and sigmoid colon if lower pelvic mass or pathology is suspected In some cases air may be substituted for a positive contrast agent The use of vaginal tampon may be helpful in adult female patients with suspected pelvis pathology To further optimize MPR image quality we recomm...

Page 166: ...trast detectability is improved by using B31s B41s instead of B30s B40s The 2 kernels B35s and B46s are especially designed for cardiac application in particular B35s should be used for Ca scoring and B46s for patency of stents For higher sharpness as is required e g in patient protocols for cervical spine shoulder extremities thorax lung the kernels B50s B60s B70s B80s are available A special hig...

Page 167: ...167 Pelvis ...

Page 168: ... HiRes bone studies and soft tissue studies of the Hip E g evaluation of joint cavity masses trauma dysplasia necrosis of the head of the hip congruence evaluations orthopedic indications etc A typical range of 20 cm will be covered in 24 2 sec ...

Page 169: ...50 overlapping and kernel B10s If only one side is examined it is advisable to enter the side in the comment line on the routine card MPRthick Hip coronal Image thickness 3 Distance between images 3 Number of images 20 For the 2nd reconstruction the Autoload into the MPR Range on the 3D Card is activated The images will be automatically loaded into 3D MPR and a coronal MPRthick Range will pop up P...

Page 170: ...elvis PelvisRoutine Indications Spiral mode for routine pelvis studies E g processes of the prostate urinary bladder rectum gynecological indications etc A typical range of 20 cm will be covered in 13 1 sec ...

Page 171: ...otation time 1 0 sec Kernel B41s Increment 5 0 mm Image order cr ca CTDIVol 11 9 mGy If the examination performed requires a full urinary bladder wait at least 3 minutes following IV admini stration of the contrast medium Contrast medium IV injection Start delay 50 sec Flow rate 2 0 3 0 ml sec Total amount 100 120 ml ...

Page 172: ...w SpineRoutineSeq Sequence mode for routine spine studies SpineObeseSeq Sequence mode for studies of obese patients Spine Spiral mode for thoracal lumbar studies C Spine Thin slice spiral mode for cervical spine studies ...

Page 173: ...uced by 50 Use kernel B10 and 50 overlapping image reconstruction For lumbar studies place a cushion under the patient s knee This will reduce the curve in the spine and also make the patient more comfortable The CT scan following myelography must be per formed within 4 6 hours of the injection otherwise the contrast density in the spinal canal will be too high to obtain artifact free images Also ...

Page 174: ...trast detectability is improved by using B31s B41s instead of B30s B40s The 2 kernels B35s and B46s are especially designed for cardiac application in particular B35s should be used for Ca scoring and B46s for patency of stents For higher sharpness as is required e g in patient protocols for cervical spine shoulder extremities thorax lung the kernels B50s B60s B70s B80s are available A special hig...

Page 175: ...175 Spine ...

Page 176: ...L4 L5 L5 S1 The scan length of each range is 2 8 cm Three different typical gantry tilts are predefined for L3 L4 0 for L4 L5 5 and for L5 S1 15 SpineRoutineSeq L3 4 L4 5 L5 S1 kV 130 mAs 280 280 320 Slice collimation 1 0 mm Slice width 2 0 mm Feed Scan 6 0 mm Rotation time 1 5 sec Kernel B31s Cycle time 3 0 sec Image order cr ca CTDIVol 36 9 mGy 36 9 mGy 42 2 mGy ...

Page 177: ...tains three ranges L3 L4 L4 L5 L5 S1 The scan length of each range is 2 8 cm Three different typical gantry tilts are predefined for L3 L4 0 for L4 L5 5 and for L5 S1 15 SpineObeseSeq L3 4 L4 5 L5 S1 kV 130 mAs 320 320 370 Slice collimation 1 0 mm Slice width 2 0 mm Feed Scan 6 0 mm Rotation time 1 0 sec Kernel B31s Cycle time 2 5 sec Image order cr ca CTDIVol 42 2 mGy 42 2 mGy 48 8 mGy ...

Page 178: ...178 Spine Spine Indications Spiral mode for thoracic and lumbar spine studies e g prolapse degenerative changes trauma tumors etc A range of 15 cm will be covered in 20 8 sec ...

Page 179: ... CTDIVol 21 6 mGy MPRthick Spine coronal Image thickness 3 Distance between images 3 Number of images 30 For the 2nd reconstruction the Autoload into the MPR Range on the 3D Card is activated The images will be automatically loaded into 3D MPR and a coronal MPRthick Range will pop up Please notice if you are not satisfied with the Range preset adapt the parameters to your needs and link them to th...

Page 180: ...180 Spine C Spine Indications Spiral mode for cervical spine studies e g prolapse degenerative changes trauma tumors etc A range of 15 cm will be covered in 27 sec ...

Page 181: ...CTDIVol 19 8 mGy MPRthick C Spine sagittal Image thickness 3 Distance between images 3 Number of images 20 For the 2nd reconstruction the Autoload into the MPR Range on the 3D Card is activated The images will be automatically loaded into 3D MPR and a sagittal MPRthick Range will pop up Please notice if you are not satisfied with the Range preset adapt the parameters to your needs and link them to...

Page 182: ...piral studies AngioRunOff06s For long range CTA spiral studies using a rotation time of 0 6 sec optional ExtrCombi Combination for HiRes bone and soft tissue spiral studies ExtrHR Spiral mode for bone High Resolution studies using 0 5 mm collimation optional ...

Page 183: ...nd feet together The only exceptions are extremely light patients The latter can remove the leg not being examined from the gantry by bending it 90 at the hip and the knee and placing the bottom of the same foot against the gantry casing c For ankle and feet scan Patient lying in supine position feet first Bind both ankles together if necessary to assure the AP position of both feet Special positi...

Page 184: ...s For higher sharpness as is required e g in patient protocols for cervical spine shoulder extremities thorax lung the kernels B50s B60s B70s B80s are available A special high resolution lung kernel is supplied with B90s by using kernel B90s practically the same image impression is obtained as with HCE filtering of a B40s image The special kernels are mostly used for physical measurements with pha...

Page 185: ...185 Extremities ...

Page 186: ...es A range of 80 cm will be done in 31 2 sec AngioRunOff kV 110 Effective mAs 90 Slice collimation 2 0 mm Slice width 3 0 mm Feed Rotation 21 6 mm Rotation time 0 8 sec Kernel B31s Increment 1 5 mm Image order cr ca CTDIVol 7 0 mGy Extremities ...

Page 187: ...he feet together if necessary Extremities Contrast medium IV injection Start delay 25 30 sec Flow rate 3 0 3 5 ml sec Total amount 120 150 ml MIPthin AngioRunOff coronal Image thickness 3 Distance between images 3 Number of images 35 For the 1st reconstruction the Autoload into MIPthin Range on the 3D Card is activated The images will be automatically loaded into 3D MIPthin and a coronal MIPthin R...

Page 188: ...tion time 0 6 sec A range of 80 cm will be done in 23 4 sec AngioRunOff kV 110 Effective mAs 90 Slice collimation 2 0 mm Slice width 3 0 mm Feed Rotation 21 6 mm Rotation time 0 6 sec Kernel B31s Increment 1 5 mm Image order cr ca CTDIVol 7 0 mGy Extremities ...

Page 189: ...e feet together if necessary Extremities Contrast medium IV injection Start delay 25 30 sec Flow rate 3 0 3 5 ml sec Total amount 120 150 ml MIPthin AngioRunOff coronal Image thickness 3 Distance between images 3 Number of images 35 For the 1st reconstruction the Autoload into MIPthin Range on the 3D Card is activated The images will be automatically loaded into 3D MIPthin and a coronal MIPthin Ra...

Page 190: ... trauma disorders of the joint etc A range of 10 cm will be covered in 10 5 sec Extremity 2nd reconstr kV 130 Effective mAs 40 Slice collimation 1 0 mm Slice width 5 0 mm 1 25 mm Feed Rotation 9 0 mm Rotation time 0 8 sec Kernel B41s B70s Increment 5 0 mm 0 8 mm Image order cr ca CTDIVol 5 3 mGy Extremities ...

Page 191: ...30 For the 2nd reconstruction the Autoload into the MPR Range on the 3D Card is activated The images will be automatically loaded into 3D MPR and a coronal MPRthick Range will pop up Please notice if you are not satisfied with the Range preset adapt the parameters to your needs and link them to the series ...

Page 192: ...192 ExtrHR Indications Spiral mode for HiRes bone study E g trauma ortho pedic indications etc A range of 10 cm will be covered in 35 3 sec Extremities ...

Page 193: ...0 5 mm Slice width 0 63 mm Feed Rotation 3 0 mm Rotation time 1 0 sec Kernel U90s Increment 0 3 mm Image order cr ca CTDIVol 6 8 mGy This protocol is used for High Resolution studies For image reconstruction of soft tissue use kernel H30s H31s Extremities ...

Page 194: ...local Siemens Sales Representative for the most current information Original images always loose a certain amount of detail when reproduced Siemens AG Medical Solutions Computed Tomography Siemensstrasse 1 D 91301 Forchheim Germany www SiemensMedical com Order No A91100 M2100 2226 1 7600 Printed in Germany BKW 42226 BA 05033 ...

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